Fluids & Electrolytes

central nervous system changes

the nurse must be alert for [3 blanks] changes such as lethargy, seizures, confusion, and muscle twitching.

high-sodium liquids

the nurse should encourage intake of [blank-sodium] liquids to correct hyponatremia.

8 hours

the nurse should monitor for fluid I&O at least every [blank] hours, or even hourly.

acid-base

[blank-blank] balance is another important aspect of homeostasis.

ABG analysis

[blank] analysis may reveal acid-base imbalances.

fluid and electrolyte

[blank] and [blank] balance is vital for proper functioning of all body systems.

nutrients and oxygen waste products

[blank] and [blank] should enter body cells while [2 blanks] should exit the body.

hypermagnesemia

[blank] are magnesium serum levels over 2.3 mg/dl.

hypocalcemia

[blank] are serum calcium levels below 8.6 mg/dl.

calcitonin

[blank] can be used to lower the serum calcium level and is particularly useful for patients with heart disease or heart failure who cannot tolerate large sodium loads.

feedback

[blank] is the relaying of information about a given condition to the appropriate organ or system.

filtration

[blank] is the transport of water and dissolved materials concentration already exists in the cell.

hematocrit

[blank] levels in FVD are greater than normal because there is a decreased plasma volume.

BUN

[blank] may be decreased in fluid volume excess (FVE) due to plasma dilution.

hemodialysis or peritoneal dialysis

[blank] or [2 blanks] is performed to remove nitrogenous wastes and control potassium and acid-base balance, and to remove sodium and fluid.

hypomagnesemia

[blank] refers to a below-normal serum magnesium concentration.

hyperkalemia

[blank] refers to a potassium level greater than 5.0 mEq/L.

hyponatremia

[blank] refers to a serum sodium level that is less than 135 mEq/L.

antidiuretic hormone (ADH)

[blank] regulates the amount of water the kidney tubules absorb and is released in response to low blood volume or in response to an increase in concentration of sodium and other solutes in the intravascular fluids.

vital signs

[blank] signs should be closely monitored.

hypokalemia

[blank] usually indicates a deficit in total potassium stores.

diffusion

[blank], or the process of "being widely spread", is the random movement of molecules from an area of higher concentration to an area of lower concentration.

diuretics

[blanks] are commonly given for systemic edema.

electrolytes

[blanks] are found in the form of inorganic salts, acids, and bases.

diets

[blanks] low or excessive in electrolytes could also cause electrolyte imbalances.

fluids

[blanks] make up a large portion of the body, which is approximately 50-60% of the total body weight.

buffer

a [blank] is a chemical system set up to resist changes, particularly in hydrogen ion levels.

salt

a [blank] is a combination of a base and an acid and is created when the positive ions of a base replace the positive hydrogen ions of an acid.

base

a [blank] or alkali is a compund that contains the hydroxyl ion.

hydrogen

a change in the pH of a solution by one pH unit means a tenfold change in [blank] concentration.

levels of intake

approximate [3 blanks] include fluids 1,200 ml, foods 1,000 ml, and metabolic products 30 ml.

external

[blank] causes of dehydration include prolonged sun exposure and excessive exercise, as well as diarrhea, vomiting, and burns.

trauma

[blank] causes release of intracellular potassium which is extremely dangerous.

ECG

[blank] changes can also contribute to the diagnosis of fluid and electrolyte imbalances.

urine

[blank] concentration. obtain [" "] sample of the patient to check for [" "] concentration.

physical exam

[blank] exam is needed to reinforce other data about a fluid or an electrolyte imbalance.

intracellular fluid

[blank] fluid functions as a stabilizing agent for the parts of the cell, helps maintain cell shape, and assists with transport of nutrients across the cell membrane, in and out of the cell.

extracellular fluid

[blank] fluid mostly appears as interstitial tissue fluid and intravascular fluid.

electrolytes

[blank] in body fluids are active chemicals or cations that carry positive charges and anions that carry negative charges.

bicarbonate

[blank] ions are basic components in the body, and the kidneys are key in regulating the amount of bicarbonate in the body.

sodium

[blank] ions outnumber any other cations in the ECF; therefore it is essential in the fluid regulation of the body.

dehydration

[blank] is a deficiency of body water or excessive loss of water.

Lasix

[blank] is a diuretic commonly prescribed for patients with mild fluid volume excess; blocks sodium reabsorption in the distal tubule.

hyperphosphatemia

[blank] is a serum phosphorus level that exceeds 4.5 mg/dl in adults.

hypernatremia

[blank] is a serum sodium level higher than 145 mEq/L.

overhydration

[blank] is an excess of water in the body.

edema

[blank] is caused by a disruption of the filtration and osmotic forces of the body's circulating fluids.

hypophosphatemia

[blank] is indicated by a a serum phosphorus level value below 2.5 mg/dl.

water

[blank] is retained abnormally in SIADH.

hypercalcemia

[blank] is serum calcium levels greater than 10.2 mg/dl.

osmosis

[blank] is the diffusion of a pure solvent, such as water, across a semipermeable membrane in response to a concentration gradient in situations where the molecules of a higher concentration are non diffusible.

homeostasis

[blank] is the dynamic process in which the body maintains balance by constantly adjusting to internal and external stimuli.

edema

[blank] is the excess accumulation of fluid in interstitial tissue spaces, also called third-space fluid.

diffusion

[blank] is the natural tendency of a substance to move in an area of higher concentration to an area of lower concentration.

hypermagnesemia

Signs and symptoms are flushing, hypotension, muscle weakness, drowsiness, hypoactive reflexes, depressed respirations, and diaphoresis.

hyponatremia

Signs and symptoms include anorexia, nausea and vomiting, headache, lethargy, dizziness, confusion, muscle cramps and weakness, muscular twitching, seizures, dry skin, and edema.

hyperkalemia

Signs and symptoms include muscle weakness, tachycardia, paresthesia, dysrhythmias, intestinal colic, cramps, abdominal distention, and anxiety.

hypophosphatemia

Signs and symptoms include paresthesias, muscle weakness, bone pain and tenderness, chest pain, confusion, seizures, tissue hypoxia, and nystagmus.

passive transport

[2 blanks] mechanisms include diffusion, osmosis, and filtration.

respiratory alkalosis

[2 blanks] occurs as a result of hyperventilation or excess aspirin intake.

normal output

[2 blanks] occurs as urine, breathing, perspiration, feces, and in minimal amounts of vaginal secretions.

respiratory acidosis

[2 blanks] occurs when breathing is inadequate and PaCO2 builds up.

daily output

[2 blanks] should approximately equal intake.

fluid volume deficit

Clinical signs and symptoms include acute weight loss, decreased skin turgor, oliguria, concentrated urine, orthostatic hypotension, a weak, rapid heart rate, flattened neck veins, increased temperature, thirst, decreased or delayed capillary refill, cool, clammy skin, muscle weakness, and cramps.

hypokalemia

Clinical manifestations are fatigue, anorexia, muscle weakness, polyuria, decreased bowel motility, paresthesia, ileus, abdominal distention, and hypoactive reflexes.

hyperphosphatemia

Clinical manifestations are tetany, tachycardia, anorexia, nausea and vomiting, muscle weakness, and hyperactive reflexes.

hypomagnesemia

Clinical manifestations include neuromuscular irritability, positive Trousseau's and Chvostek's sign, insomnia, mood changes, anorexia, vomiting, and increased deep tendon reflexes.

loss decreased

FVD (fluid volume deficit) results from [blank] of body fluids and occurs more rapidly when coupled with [blank] fluid intake.

The RAA system

The [blank] system controls fluid volume, in which when the blood volume decreases, blood flow to the renal juxtaglomerular apparatus is reduced, thereby activating the system.

hypocalcemia

The signs and symptoms are numbness, tingling of fingers, toes, and circumoral region, positive Trousseau's sign and Chvostek's sign, seizures, hyperactive deep tendon reflexes, irritability, and bronchospasm.

hypernatremia

The signs and symptoms are thirst, elevated body temperature, hallucinations, lethargy, restlessness, pulmonary edema, twitching, increased BP and pulse.

hypercalcemia

The signs and symptoms include muscle weakness, constipation, anorexia, nausea and vomiting, dehydration, hypoactive deep tendon reflexes lethargy, calcium stones, flank pain, pathologic fractures, and deep bone pain.

active transport

[2 blank] mechanisms require specific enzymes and an energy expenditure in the fomr of adenosine triphosphate (ATP).

sodium bicarbonate and carbonic acid

[2 blanks] and [2 blanks] are the body's major chemical buffers.

supplemental fluids and electrolytes

[2 blanks] and [blanks] are often administered to treat dehydration.

I&O (intake&output)

accurate and frequent assessments of [blanks] should be performed when therapy should be slowed or increased to prevent volume deficit or overload.

processes

active transport [blnaks] can move solutes "uphill", against the normal rules of concentration and pressure.

oral or parenteral fluids

administer [blank] or [blank] fluids as indicated to correct the deficit.

diet fluid intake follow-up (eval of electrolyte and fluid status) medications

after hospitalization, treatment and maintenance of the condition must continue at home; discharge and home care guidelines include: (4)

electrolyte

an [blank] is a substance that will disassociate into ions when dissolved in water.

acid

an [blank] is one type of compound that contains the hydrogen ion.

2,500 ml

an adult human at rest takes approximately [blank] ml of fluid daily (daily intake).

daily

assess the patient's weight [blank] to measure any gains or losses.

positive

blood clotting after an injury and a woman in labor are examples of [blank] feedback.

negative

blood pressure control and maintenance of normal body temperature are examples of [blank] feedback.

intracellular and extracellular space

body fluid is located in two fluid compartments: the [blank] and the [blank]

intracellular and extracellular

body fluids are divided between two main compartments: the [blank] fluid and the [blank] fluid compartments

FVE (fluid volume excess)

clinical manifestations for [blank] include edema, distended neck veins, and crackles.

tetany

decreased levels of calcium and magnesium leads to [blank].

electrical charge

each chemical element has an [2 blanks], either positive or negative.

concentrations

electrolyte [blanks] vary from those in the ICF to those in the ECF.

chemical activity milliequivalents

electrolyte concentrations are measured according to their [2 blanks] and expressed as [blanks].

loss

excessive [blank] of sodium is associated with decreased volume of body fluid.

dynamic homeostasis

fluid and electrolyte balance is a [blank] process that is crucial for life and [blank].

60%

fluid occupies almost [%] of the weight of an adult.

dehydration

fluid volume deficit could result in [blank] of the body tissues.

hypovolemia

fluid volume deficit or [blank] occurs when loss of ECF volume exceeds the intake of fluid.

cardiac overload

fluid volume excess could result in [2 blanks] if left untreated.

simple fluid overload

fluid volume excess may be related to a [3 blank] overload or diminished function of the homeostatic mechanism responsible for regulating fluid balance.

hypervolemia

fluid volume excess or [blank] refers to an isotonic volume expansion of the ECF caused by the abnormal retention of water and sodium in approximately the same proportions in which they normally exist in the ECF.

IV calcium gluconate

if serum potassium levels are dangerously elevated, it may be necessary to administer IV [2 blanks].

neutral

if the pH is 7, then the solution is [blank].

basic

if the pH is greater than 7, a solution is [blank] or alkaline.

acid

if the pH number is lower than 7, the solution is a(n) [blank].

more than body requirements

imbalance nutrition: related to excessive intake.

less than body requirements

imbalance nutrition: related to inability to ingest food or absorb nutrients.

intracellular

important [blank] electrolytes are potassium, magnesium, sulfate, and phosphate.

extracellular

important [blank] electrolytes include sodium, chlorine, calcium, and bicarbonate.

metabolic acidosis

in metabolic [blank], metabolism is impaired, causing a decrease in bicarbonates and a buildup of lactic acid.

electrolyte

measurement of [blank] levels should be performed to check for presence of an imbalance.

metabolic alkalosis

metabolic [blank] occurs when bicarbonate ion concentration increases, causing an elevation in blood pH.

turgor

monitor [blank]. skin and tongue [" "] are indicators of the fluid status of the patient.

reverses

negative feedback occurs when the body [blanks] an original stimulus for the body to regain physiologic balance.

Maintenance of fluid volume at a functional level. Display of normal laboratory values. Demonstration appropriate changes in lifestyle and behaviors including eating patterns and food quantity/quality. Reestablishment and maintenance of normal pattern and GI functioning.

planning and goals for fluid and electrolyte imbalances include: (4)

enhances

positive feedback [blanks] or intensifies the original stimulus.

deficient fluid volume

related to active fluid loss or failure of regulatory mechanisms.

diarrhea

related to adverse effects of medications or malabsorption.

excess fluid volume

related to excess fluid intake and sodium intake.

sodium

retention of [blank] is associated with fluid retention.

potassium

the ECF has a low concentration of [blank] and can tolerate only small changes in its concentrations.

pH level gases

the [2 blanks] and amounts of specific [blanks] in the blood indicate if there is more acid or base and their associated values.

cell membrane

the [2 blanks] separates the intracellular environment from the extracellular environment.

permeability

the ability of a membrane to allow molecules to pass through is known as [blank].

salts

the body contains several important [blanks] like sodium chloride, potassium chloride, calcium chloride, calcium carbonate, calcium phosphate, and sodium phosphate.

cell membrane pumps

the body expends a great deal of energy in maintaining the sodium and potassium concentrations through [3 blanks] that exchange sodium and potassium ions.

selectively

the cell membrane is [blank] permeable, meaning that each cell's membrane allows only certain specific substances to pass through.

hormones

the endocrine system uses the release and action of [blanks] to maintain homeostasis.

atrial natriuretic peptide (ANP)

the heart also plays a role in correcting overload imbalances, by releasing [3 blanks] the right atrium.

anions

the major [blanks] are chloride, bicarbonate, sulfate, and proteinate ions.

cations

the major [blanks] in the body fluid are sodium, potassium, calcium, magnesium, and hydrogen ions.

CO2

the major compound controlled by the lungs is [blank].

nervous and endocrine

the major systems invovled in feedback are the [blank] and [blank] systems.

potassium phosphate

the most dominant intracellular cation is [blank] and the most dominant anion is [blank].

sodium chlorine

the most essential extracellular cation is [blank] while [blank] is the most important anion.

nerve impulses

the nervous system regulates homeostasis by sensing system deviations and sending [2 blanks] to appropriate organs.

encourage restrict

the nurse must [blank] intake of electrolytes that are deficient or [blank] intake if the electrolyte levels are excessive.

respiratory rate CO2

the respiratory system can very rapidly compensate for too much acid and too little acid by increasing or decreasing the [2 blanks], thereby altering the level of [blank].

pH

the symbol of [blank] refers to the potential or power of hydrogen ion concentration within the solution.

hypothalamus

the thirst center in the [blank] stimulates or inhibits the desire for a person to drink.

medications

there are certain [blanks] that could lead to electrolyte imbalances when taken against the physicians orders.

fluid volume

there are different [2 blank] disturbances that may affect an individual.

AVP receptor agonists

these are new pharmacologic agents that treat hyponatremia by stimulating free water excretion.

freely permeable membranes

these membranes allow almost any food or waste substance to pass through .

isotonic electrolyte solutions

these solutions are used to treat the hypotensive patient with FVD because they expand plasma volume.

oral rehydration solutions

these solutions provide fluid, glucose, and electrolytes in concentrations that are easily absorbed.

electroneutrality

this is the balance of positive and negative charges.

osmolarity

this is the property of particles in a solution to dissociate into ions.

diuretics

to decrease fluid volume in FVE, [blanks] are administered.

cardiac arrest

too much potassium administered could lead to [2 blanks].

electrolyte concentration

total [2 blanks] affects the body's fluid balance.

restrictions or enforcement

treatment of fluid and electrolyte imbalances should involve [blanks] or [blank] of the concerned electrolyte.

physical examination

what type of exam is necessary to observe the signs and symptoms of the imbalances?

low to high

when two different solutions are separated by a membrane that is impermeable to the dissolved substances, fluid shifts from the region of [blank] solute concentration to the [blank] solute concentration until the solutions are of equal concentrations.